Carbapenemase-producing Gram-negative bacteria: Current epidemics, antimicrobial susceptibility and treatment options

Shio Shin Jean, Wen Sen Lee, Carlos Lam, Chin Wang Hsu, Ray Jade Chen, Po Ren Hsueh

Research output: Contribution to journalArticlepeer-review

80 Citations (Scopus)


Carbapenemases, with versatile hydrolytic capacity against β-lactams, are now an important cause of resistance of Gram-negative bacteria. The genes encoding for the acquired carbapenemases are associated with a high potential for dissemination. In addition, infections due to Gram-negative bacteria with acquired carbapenemase production would lead to high clinical mortality rates. Of the acquired carbapenemases, Klebsiella pneumoniae carbapenemase (Ambler class A), Verona integron-encoded metallo-β-lactamase (Ambler class B), New Delhi metallo-β-lactamase (Ambler class B) and many OXA enzymes (OXA-23-like, OXA-24-like, OXA-48-like, OXA-58-like, class D) are considered to be responsible for the worldwide resistance epidemics. As compared with monotherapy with colistin or tigecycline, combination therapy has been shown to effectively lower case-fatality rates. However, development of new antibiotics is crucial in the present pandrug-resistant era.

Original languageEnglish
Pages (from-to)407-425
Number of pages19
JournalFuture Microbiology
Issue number3
Publication statusPublished - Mar 1 2015


  • Carbapenemase
  • Combination therapy
  • Dissemination
  • Gram-negative bacteria
  • Resistance

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)


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